Accurate Premium Capitated Payments and Reimbursement

Pareto Intelligence helps payers navigate Medicare Secondary Payer (MSP), Dual Eligibility, End Stage Renal Disease (ESRD), and other reporting complexities. Our data tools assist in recovering underpaid capitation payments and help mitigate compliance risk.

Using our Premium Integrity solution, our clients receive an average 5:1 return on investment, totaling over $100 million in recoveries to date.

Identify and Recover Mistaken Premium Payments


comprehensive evaluation of Medicare Advantage premium reconciliation

We uncover and correct inaccuracies in the information reported to CMS for MSP validation. Additionally, we help reconcile inconsistencies in data between the MMR and claims data to properly classify ESRD status and recover appropriate payments for those members.

Identify and recover mistaken premiums

Dual Eligibility

enrollment And recertification

Our Dual Eligibility Identification Model and Enrollment Services help plans improve member experience, expand benefits, and increase retention. Our data tools improve premium accuracy and can predict dual status on average with up to 95% accuracy.

Manage Your Dual Eligible Beneficiaries


Improve Dual Eligibility Enrollment
Medicare Secondary Payer Status
ESRD Determinations
Correct CMS Overpayments
MA Premium Reconciliation
Mitigate Compliance Risk
Outreach and Enrollment
Recoup Underpayments

A Powerful Foundation


Our Data Management Platform

Pareto’s Data Management Platform, the foundation to our solutions, is built around data lake, artificial intelligence, and open source big data technologies to allow us to effectively ingest data in all formats and types at scale, organize them with appropriate data governance mechanisms within our data catalog, and provide efficient configuration capabilities to democratize data access and analytics.


See it and Believe it

Our demos say it all. Tell us about your challenges and we’ll show you how we can help you overcome them.

Schedule a Demo